NOA Demo Test Scenarios
| Scenario | Member ID | Notification Receipt Number | Segments |
|---|---|---|---|
| Successful Notification | TEST1 | 123456789 | REF_BAF_123456789~HCR*A6~ REF*BAF goes in the 2000C/D |
| Duplicate Notification | TEST2 | 987654321 | REF_BAF_987654321~AAA_N*_33_N~HCR_A3~ REF*BAF goes in the 2000C/D AAA33 goes in 2000E |
| Ineligible | TEST3 | N/A | AAA_N**95_N~ AAA95 goes in 2010C/D |
| Delayed Response | TEST4 | 456123789 | AAA_N**42_Y~REF_BAF_456123789~ REF*BAF goes in the 2000C/D AAA42 goes in 2010B |
| Pending | TEST5 | N/A | HCR*A4~ |
| Notification Not Required | TEST6 | N/A | HCR*NA~ |
ISA*00* *00* *ZZ*[submitterid] *ZZ*NOADEMO *260324*1655*^*00501*292156293*0*P*:~GS*HI*[submitterid]*NOADEMO*20260324*1655*1234*X*005010X216~ST*278*0001*005010X216~BHT*0007*CN*3164218000N1*20260324*1655*NO~HL*1**20*1~NM1*FA*2*[FACILITY NAME]*****XX*[NPI]~REF*ZH*[MPIN]~N3*[STREET ADDRESS]~N4*[CITY]*[STATE]*[ZIP]~PER*IC*[CONTACT NAME]*TE*[TELEPHONE NUMBER]~HL*2*1*21*1~NM1*PR*2*DEMO NOA PAYER*****PI*NOADEMO~HL*3*2*22*1~NM1*IL*1*[PATIENT LAST NAME]*[PATIENT FIRST NAME]****MI*[MEMBER ID]~REF*6P*[GROUP NUMBER]~DMG*D8*[DOB]~HL*4*3*EV*0~UM*AR*I*1*21:A~DTP*435*D8*[ADMISSION DATE]~DTP*096*D8*[DISCHARGE DATE]HI*ABJ:[DIAGNOSIS CODE]~CL1*[ADMISSION TYPE CODE]~NM1*FA*2*[FACILITY NAME]*****XX*[NPI]~REF*ZH*[MPIN]~N3*[STREET ADDRESS]~N4*[CITY]*[STATE]*[ZIP]~NM1*AAJ*1*[ADMITTING PHYSICIAN LAST NAME]*[ADMITTING PHYSICIAN FIRST NAME]****XX*[NPI]~SE*26*0001~GE*1*1234~IEA*1*292156293~
Updated 1 day ago
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